کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3008047 1181441 2013 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Using extracorporeal membrane oxygenation to rescue acute myocardial infarction with cardiopulmonary collapse: The impact of early coronary revascularization ?
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Using extracorporeal membrane oxygenation to rescue acute myocardial infarction with cardiopulmonary collapse: The impact of early coronary revascularization ?
چکیده انگلیسی

ObjectivesTo investigate the therapeutic impact of combining extracorporeal membrane oxygenation (ECMO) and early coronary revascularization on acute myocardial infarction (AMI)-induced cardiopulmonary collapse.Materials and methodsThis retrospective study included 35 consecutive patients rescued by ECMO for AMI-induced cardiopulmonary collapse in a single institution between June 2003 and December 2011. Coronary revascularization was performed soon after ECMO initiation. Percutaneous coronary intervention (PCI) was the primary revascularization strategy. Coronary artery bypass grafting (CABG) was performed if an unsuitable anatomy or unsatisfactory result of PCI. Comparisons were performed in groups with different revascularization strategies and outcomes.ResultsAmong the 35 patients, 16 underwent CABG and 1 was bridged to transplant after CABG. Compared to patients receiving PCI only, the CABG group showed similar results in ECMO weaning (58% vs. 69%, p = 0.51), hospital discharge (32% vs. 50%, p = 0.27), and left ventricular ejection fraction before discharge (45% vs. 49%, p = 0.92). Regardless of revascularization strategies, this protocol achieved an ECMO-weaning rate of 63% and a hospital discharge rate of 40%. Dialysis-dependent acute renal failure (OR 5.4, 95% CI: 1.1–27.5) and profound anoxic encephalopathy (OR 5.4, 95% CI: 1.1–27.5) predicted non-weaning of ECMO. Age > 60 years (OR 7.3, 95% CI: 1.1–51.0) and profound anoxic encephalopathy (OR 24.6, 95% CI: 2.3–263.0) predicted in-hospital mortality. The major cardiovascular adverse effect (MACE)–free survival was 77% in the first year after discharge.ConclusionEarly revascularization on ECMO is practical to preserve myocardial viability and bridge patients collapsing with AMI to recovery.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Resuscitation - Volume 84, Issue 7, July 2013, Pages 940–945
نویسندگان
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